Foreign Bodies in the Skin: Evaluation and Management

Foreign bodies may be introduced into the skin through lacerations and soft tissue wounds. Long-term complications of retained foreign bodies include chronic pain and neurovascular impairment. Wound exploration and initial imaging with radiography or ultrasonography should be considered before foreign body removal. Risks and benefits of removal should be discussed with the patient. Although some foreign bodies may be left in place, removal should be considered if the risk of complications is high. A cooperative patient and adequate wound visualization are important for successful foreign body removal. Adequate analgesia and judicious use of anxiolytics and sedation may be helpful. Wound irrigation with normal saline or tap water is recommended after foreign body removal. Antiseptic solutions for wound irrigation may impair healing and should be avoided. Although there is no consensus on the use of antibiotic prophylaxis, several indications exist. The patient's tetanus immunization history should be reviewed, and vaccine should be administered if indicated.